Earlier this week, the World Health Organization declared that Liberia, where nearly five thousand people died in the past year’s outbreak of Ebola, was officially free of the virus. It has been forty-two days, double the longest known incubation period, since a new case had been reported there.
Government officials called for a well-deserved national day of celebration; the victory is a remarkable achievement in an impoverished country that, even now, largely lacks rudimentary health-care facilities. But before we wish away the epidemic that obsessed and terrified America for several weeks last year (until our own safety permitted us to stop caring), it ought to be mentioned that Ebola continues to kill people in Sierra Leone and Guinea—and that it appears that many of the deaths in the region could have been avoided if the World Health Organization had responded to the outbreak more rapidly.
That is the initial conclusion of a harsh new report released by a group known as the Ebola Interim Assessment Panel, which was commissioned by the W.H.O. in March. The findings demonstrate how poorly prepared we are for any global pandemic, and underscore, yet again, how little lasting regard the West seems to have for the people and problems of Africa. (Yes, as President Obama said, when dispatching troops and money to help the fight, “We can’t dawdle on this one.” But that was in September, 2014, months after the gravity of the epidemic was clear.) The report also noted that in a world where almost any incubation period is longer than even the farthest plane ride, we are all only as safe as our most vulnerable nations.
“It is still unclear to the panel why early warnings, approximately from May through to July 2014, did not result in an effective and adequate response,’’ the panel, led by Barbara Stocking, the former chief executive of Oxfam in the United Kingdom, and now the president of Cambridge’s Murray Edwards College, wrote. “Although WHO drew attention to the ‘unprecedented outbreak’ at a press conference in April 2014, this was not followed by international mobilization and a consistent communication strategy. The countries most affected, other WHO Member States, the WHO Secretariat, and the wider global community were all ‘behind the curve’ of the rapid spread of the Ebola virus.’’
Almost thirty-five years into the global AIDS pandemic, with nearly forty million lives lost to that disease, it seems appropriate to ask how many epidemics we will need to endure before we catch up to that “curve.” The world seems to have learned little from its experience with SARS, Avian Influenza, and the pandemic of H1N1 that began in 2009. (That virus, which infected a billion people, turned out to be far less deadly than many other influenza strains. And yet it still killed tens of thousands of people.)
Viruses don’t decide how deadly to be; for humanity, H1N1’s relative lack of virulence was just plain luck. But few epidemiologists think that such luck can last, or that there won’t be another global pandemic—perhaps a more deadly form of the flu, or an entirely new virus. And yet, at a time when we know so much about the molecular composition of viruses, each time an epidemic erupts we act with an almost identical mixture of fear, surprise, and confusion. As the W.H.O. panel put it this week:
No such systems were functioning properly at the beginning of the Ebola epidemic. The epidemic was first reported last March, and its severity had been well documented (particularly by aid groups such as Doctors Without Borders, whose work dealing with sick and dying Ebola patients was heroic.) Yet, Ebola was not declared an emergency until August 8th. By then, nearly a thousand people had already died. Why?
W.H.O. documents have shown that the organization’s leaders were informed of how desperate the situation was, but that officials there resisted declaring an emergency in part because it would have angered the countries affected and interfered with tourism and travel (including for the annual pilgrimage to Mecca). This negligence would be unforgivable in any instance, but it is not the first time that global health and political leaders have let politics interfere with the lives of millions of people. If SARS had been more contagious, it would have created the new millennium’s first grave public-health crisis. And yet, in 2002, after it first appeared, Chinese leaders, worried about trade and tourism, lied about the presence of the virus for months—insuring that it would spread. In 2004, when avian influenza first surfaced in Thailand, officials there displayed a similar reluctance to release information.
We in the West deserve a heavy share of the blame for the intensity of the Ebola epidemic. We managed to express hysteria at home while paying little attention to the people who were truly affected. During America’s infection with Ebola Fear, which had a more powerful impact in this country than the actual virus, the press and political leaders managed to denigrate the people who sacrificed the most to fight the epidemic in Africa. The W.H.O. has acknowledged acting too slowly. But it is hard to argue with the conclusion of the new report: “ ‘Business as usual’ or ‘more of the same’ is not an option.” That verdict should, clearly, also apply to the world’s richest countries.
Will anyone listen? It is long past time to recognize that unless we improve the capacity of every country to stop threats like Ebola, more needless fear, and many preventable deaths, are inevitable.
